Studies of dietary habits in pregnancy - with special reference to the intake of iron. The dietary habits of 94 pregnant women (median age 26 years) were studied by means of four-day dietary records. Twenty-seven women were followed longitudinally and were observed in the 10-15th, the 24-27th and the 34-37th week of gestation (L-series). The remaining 67 women comprised the A-series, of which 20, 32, and 15 made their records during the 10-15th, 24-27th, and 34-37th week of gestation, respectively. There were no significant differences between the results from these two series. The mean daily energy intake was 2360 kcal and remained unchanged during pregnancy, exceeding by 250 kcal the average intake in non-pregnant women in Gothenburg, studied earlier. The iron intake comprised 1-2 mg of haeme iron, about 10 mg of native non-haeme iron and 5-6 mg of fortificiation iron. The mean iron intake was 7.2 mg/1000 kcal, which is below the recommendation, but it was distributed over the food groups in a manner more favourable for iron absorption than in the average Swedish population. Further effects to improve the diet so as to increase the content of iron and factors known to favour iron absorption are desirable. The results justify the normal practice of prescribing supplement iron in late pregnancy.


Inhibition of glucose-6-phosphate dehydrogenase activity by tretinoin. A contribution on the biochemical effects of tretinoin and on the rationale for using this compound in antipsoriatic therapy.


Dietary iron absorption in pregnancy - a longitudinal study with repeated measurements of non-haeme iron absorption from whole diet. In 22 healthy women the non-haeme iron absorption (bone-marrow smears and haematological parameters) was studied at the 12th, the 24th and the 36th week of gestation and two months after delivery. In eight non-pregnant women and in seven pregnant women (at the 36th week of gestation) the absorption of food iron was measured from different types of meals. The iron absorption was measured from radioiron-labelled test meals using a whole-body counter with a very high sensitivity. During pregnancy the non-haeme iron absorption increased continuously from less than 1 % in early pregnancy to almost 15 % in late pregnancy. Calculations indicated that the amount of iron absorbed from the diet covered only about half of the demands. The increasing absorption of food iron during pregnancy seems to be related to the still more increasing demands. However, the very low absorption values in early pregnancy was quite unexpected. The amount of iron absorbed was actually below the basal demands, which means that even in early pregnancy, for reasons unknown, there is a negative iron balance. Further studies are necessary to elucidate the significance of this finding. Two months after delivery the absorption of iron from the diet was increased compared to in non-pregnant women and exceeded the demands at that phase thus indicating that a positive iron balance was achieved.


Iron absorption in early pregnancy - a study of the absorption of non-haeme iron and ferrous iron in early pregnancy. The absorption of non-haeme iron in the food and from a 3 mg reference dose of ferrous iron in solution was measured in 17 healthy women before the 12th week of gestation and in 13 of the women two months after legal abortion. The absorption of ferrous iron in solution was calculated from determinations of the 55Fe activity in blood samples. The food iron absorption was measured from 59Fe-labelled test meals using a highly sensitive whole-body counter. In addition bone-marrow smears and other haematological parameters were studied. The median value of the absorption from the non-haeme food iron was 2.5% and from the ferrous iron salt 10.0 % in early pregnancy in women with storage iron. Two months after abortion the absorption increased to 12.6 and 42.6 % respectively. In early pregnancy the absorption of iron was higher in women without stainable iron in bone-marrow smears. The present results confirm previous observations that the absorption of food iron in early pregnancy is lower than the basal daily requirements. The low absorption is only partly explained by the reduced requirements of iron in early pregnancy. Some other factors related to pregnancy seem also to be involved.


Electron microscope findings after toxic doses of vitamin A acid in man.


From journal to tabloid in one giant step.


Absorption of supplemental iron during pregnancy - a longitudinal study with repeated bone-marrow studies and absorption measurements. Iron absorption, bone-marrow smears and haematological parameters were repeatedly studied during pregnancy in 50 women. The same studies were repeated two months after delivery. The material was randomly divided into two groups. Twenty-four women were treated with 200 mg of ferrous iron daily while 26 were given placebo. The iron absorption was measured from radioiron-labelled test doses of 100 mg ferrous iron in a whole-body counter with high sensitivity. In the placebo group the iron absorption increased throughout pregnancy from an average of 6.5 % at the 12th week to 14.3 % at the 35th week of gestation. Two months after delivery the absorption was higher than initially. In the iron-treated group the absorption increased between the 24th and 35th week of gestation from 6.0 to 8.6 %. After delivery 5.5 % of the test dose was absorbed. The haemosiderin iron in the bone-marrow was mobilized during pregnancy. In the placebo group no woman had more than trace of haemosiderin in the bone-marrow smears at the 35th week of gestation. In the iron-treated group 65 % had the same bone-marrow findings. The amount of bone-marrow haemosiderin at term seems not to have the same significance for the diagnosis of iron deficiency in pregnancy as in non-pregnant subjects. Two months after delivery about 50 % of the women in the placebo group had restored their iron deposits. In the iron-group the haemosiderin content in the bone-marrow smears was enhanced in most women compared to early pregnancy. In the placebo group haematological data indicated a high frequency of iron deficiency in late pregnancy while in the iron-treated group iron deficiency was prevented.


Advocacy presentations in dental journalism.


Strontium content of deciduous teeth in northern and southern Finland. A possible connection has been suggested between strontium and a low prevalence of dental caries. An investigation of this subject was initiated by measuring the strontium content of deciduous teeth by atomic absorption spectrophotometry in different regions in Finland. The material analysed consisted of a total of 2,482 tooth crowns and 392 tooth roots. The results showed that the Sr content of the tooth crowns in northern Finland was about two-fold that in the south, about 400 and 200 mug/gCa, respectively. The difference was apparently caused by corresponding differences in dietary strontium. The tooth roots contained much more Sr than the crowns, about 600 and 200 mug/gCa, respectively, in southern Finland, presumably owing to changes occurring in the dietary habits of the child during the development of the crowns and roots of the deciduous teeth.


Effects of vitamin A acid on cell cultures.


Breaking tradition.

Breaking tradition.


Strontium-90 in deciduous teeth in Finland. A follow-up study. Deciduous teeth of Finnish children born in 1958-1967 were analysed for strontium-90 by means of Cerenkov radiation. The strontium-90 content was about 9 pCi/gCa in children born in 1963--1964; the values decreased strongly in the subsequent cohorts of children. The strontium-90 content of the deciduous teeth varied in perfect unison with that of cow's milk (r=+0.99). The results confirm that deciduous teeth provide a practical and accurate indicator of the total body burden of bone-seeking environmental pollutants.


Denture stomatitis. Relapse tendency and removal of acquired discolourations in long-term denture disinfection with chlorhexidine. Five patients with denture stomatitis were initially treated for 14 days with a combination of amphotericin B lozenges and denture soaking in 0.2% chlorhexidine. To prevent recurrence the dentures were then kept overnight in 0.2% chlorhexidine during five months. No relapse occurred, but the dentures (all-acrylic) became heavily discoloured by chlorhexidine. During this period fungi could not be grown either on palatal or on maxillar denture agar models, and clinical signs and symptoms were reduced further. At the end of treatment hypochlorite was used to remove chlorhexidine-induced denture stain. Brushing and soaking (0.16%) proved more efficient than brushing alone, and when a 0.60% solution was used, the stains were generally eliminated in two hours. Hypochlorites in the prevention and removal of chlorhexidine discolourations deserve further attention.


Photography: the other half.

Photography: the other half.


Guide for student editors.

Guide for student editors.


The calcium orthophosphate solubilities as represented by a model in three dimensions. The construction of a model of the calcium orthophosphate solubilities has been described in detail. The model gives a true and easily comprehensible visualization of the complex interrelationships existing in phosphate systems. Examples of its application have been given as regards the stability fields, the biologic metastability, the congruent solubility, and the kinetics of dissolution and precipitation processes. As an instrument of assessing the solubilities in practical work, the usefulness of the model is further increased by including diagrammatic representations of the solubilities of Fap, CaF2, and CaCO3. The model virtually covers the whole field usually encountered in solubility studies. It is based upon an ionic strength of 0.05 and any complexation, ionic interaction, or specific ionic effects have been disregarded It is possible, however, to make the model to any scale and to construct it with a view to any purpose required.


Sex differences in craniofacial morphology. An x-ray cephalometric study was performed in a male and a female group of Danish dental students with the object of examining the sex-determined component of the cranial morphology, and of obtaining a control material for subsequent studies of pathologic samples. The cranial morphology was examined on the basis of measurements on x-ray cephalometric lateral and postero-anterior radiographs. The cranium was, on an average, smaller in the female than the male group except as regards the nasal bone, the foramen magnum and the inner orbital distance. The female group showed a more prominent frontal bone, and a less prominent nasal bone, than the male group.


Neonatal lines in human dental enamel. Occurrence in first permanent molars in males and females. The occurrence of neonatal lines (NL) in all cusps of the first permanent molar (M 1) has been investigated in complete series of M 1 from 16 males and 11 females. Previous investigations of newborn children gave reason to expect a lower frequency of occurrence in males. The present investigation showed that about one half of the males did not have NL in any of their four M 1's, while all females had NL in at least one tooth. This wound seem to indicate that on the average boys are less dentally mature at the time of birth than girls. At the same time, it opens up the possibility of a forensic sex assessment. When skeletal remains of children and young persons are in concern.


Regulation of prostaglandin E2 biosynthesis in guinea pig skin by retinoic acid. Topical application of retinoic acid on guinea pig skin resulted within 70 hours in erythema with a concomitant elevation of endogenous prostaglandin E2 (PGE2) in the treated areas of the skin. Prolonged daily treatment resulted in the development of severe scaly dermatoses and a corresponding decrease in the level of PGE2 in the skin. Examination of retinoic acid effects on the in vitro biosynthesis of PGE2 from arachidonic acid by extracts from guinea pig skin and sheep vesicular gland demonstrated that retinoic acid inhibits prostaglandin synthesis in concentration and time-dependent manner. These results indicate that retinoic acid may exert a regulatory role on prostaglandin biosynthesis in the skin.


Changing the format of the Ohio dental journal.


Vitamin A acid and wound healing.

Vitamin A acid and wound healing. After preparatory treatment with 1% vitamin A acid for 3 days, healing of standardized wounds was accelerated by 18%, compared with a control group. The histological findings revealed as causes a general activation of epidermis, resp. signs of proliferation with inhibition of normal differentiation and hornification. These well known alterations due to vitamin A acid treatment are clearly visible in all epidermal layers. Obviously the activation of epidermis occurs when a remainder of the wound normally is healing by epithelization, that is at an area of 50 mm2. The profit of time in this sense can be defined unequivocally from the performed animal experiments.


International college of dentists journalism award winners 1975.


Keeping printing costs down.

Keeping printing costs down.


Nasopharyngitis.

Nasopharyngitis.


Aspects of central integrative and efferent mechanisms in cardiovascular reflex control.


Mitotic activity in acute promyelocytic leukaemia and leukaemoid reactions. Bone marrow smears from 6 untreated patients with acute promyelocytic leukaemia (APL) and from 6 patients with leukaemoid reactions (LR) have been compared with smears from healthy controls. The mitotic indices of the granulopoietic precursor cells were significantly lower in the APL group and significantly higher in the LR group, both compared with the normals. Mitotic countings seem to be of diagnostic value for distinguishing APL from conditions simulating this disease.


The Oslo study. Cardiovascular disease in middle-aged and young Oslo men.


Case studies with carbon endosseous implants.


Clinical applications of Proplast in oral and maxillofacial surgery.


The replantation of exarticulated permanent teeth--speculation and a clinical appraisal.


The bioengineering role in dental implantology.


Childhood lymphatic leukemia: prenatal seasonality and possible association with congenital varicella. A statistically significant seasonality by month of birth, which differed for children diagnosed as having acute lymphatic leukemia in the under 2, 2-3 and 4-9-year age groups, was observed in urban counties of upstate New York. This suggested that the mothers of patients diagnosed in these three age groups might have been exposed to leukemogenic factors during different trimesters, but with each trimester consisting of the same specific group of months. Since a similar birth-month seasonality was not observed in rural regions, it seemed likely that leukemogenic factors might operate with a greater regularity in urban areas. Using these observations and reported trends for acute leukemia in the United States and New York State (excluding New York City), an effort was made to determine whether varicella, influenza, rubeola or rubella had similar epidemiologic features. Only varicella manifested both the urban-rural differences in seasonality and concomitant variations in time trends that were comparable to reported mortality trends for acute leukemia. Rank correlation coefficients for varicella and lymphatic leukemia incidence rates by month were also statistically significant when leukemia cases diagnosed in the three age groups and born in urban countries, were placed in the month of their appropriate trimesters. A retrospective search of varicella case records identified 63 instances of this viral disease complicating pregnancy. Three children resulting from these pregnancies subsequently developed acute lymphatic leukemia.


The future challenges of the dental profession.


The nature of healthy and diseased root surfaces.


Bone marrow necrosis.

Bone marrow necrosis. The clinical findings of bone marrow necrosis in 13 patients undergoing bone marrow examination to investigate a peripheral blood cytopenia or leukoerythroblastic blood smear were reviewed and compared to those in the literature. Excluding sickle cell disease, all cases of bone marrow necrosis diagnosed during life were associated with a neoplastic process involving the marrow. A myeloproliferative disorder was found in five patients, metastatic carcinoma in five patients, a lymphoma in two patients, and both a myeloproliferative disorder and metastatic carcinoma in one patient. Marrow necrosis was found to involve the marrow at multiple sites in a piecemeal fashion with areas of necrotic marrow and structurally intact marrow adjacent to each other. Severe bone pain without roentgenographic abnormality was the major symptom in 85% of the patients. Marrow and fat emboli, hypercalcemia and peripheral blood cytopenias were identified as direct complications of marrow necrosis. The prognosis of patients with marrow necrosis secondary to neoplastic disease was found to be extremely poor with a median survival of less than one month. However, one patient responded to antineoplastic chemotherapy and showed healing of the bone marrow.


The effect of different extraction sites upon incisor retraction. 1. From this study, it was found that in cases treated by the Begg technique one can anticipate greater retraction of the anterior dental units in nonextraction (see article) cases, in both types of premolar extraction cases, and in cases, involving extraction of first molars plus first premolars than would be expected on the basis of root surface area resistance values. 2. There is a likely explanation for this. Molars were maintained upright and allowed to move bodily only while incisors were not only moved bodily but often partially tipped as well. 3. The actual mean anterior retraction in first molar extraction cases exhibited a close approximation to the expected mean anterior retraction values in relation to root surface resistance values. 4. Second premolar extraction is one answer to overretraction and has the added edge of creating even less incisor retraction than second premolar extraction. 5. It was also found that the extraction of premolars alone did not result (see article) in a significant change in the increased eruption of the third molars into functional occlusion. A very significant improvement in the rate of sucessful third molar eruption was found in first molar extraction cases and in cases involving extraction of first molars plus first premolars. 6. The mean ages of the patients in the various treatment categories at the start of treatment were similar enough to each other to suggest that age at the start of treatment had no bearing on the success rate of third molar erup tion. Extraction-site selection seemed to be the dominating factor in successful third molar eruption. 7. It was found that the group of cases that exhibited the least amount of anterior retraction also inhibited the least amount of anterior relapse and, conversely, the group of cases exhibiting the greatest amount of anterior retraction also exhibited the greatest amount of anterior relapse. (see article) 8. The nonextraction cases, with no extraction space to close, were treated in the shortest mean time, while the eight-tooth (first molar plus first premolar) extraction cases having the greatest amount of extraction space required the greatest amount of mean treatment time.9. In conclusion, it can be said that changing the location of the extraction site resulted in a change in relative root surface areas of the opposing anchor units in the anterior and posterior segments. There was a definite and predictable change in the amount of anterior retraction achieved by varying the location of the extraction site. This should be considered in the diagnosis, so that a desired treatment goal for the final position of the incisors within the facial profile can be achieved.


Management of impacted canines.

Management of impacted canines. In this article an overview of the problem of impacted canines has been presented and some of the clinical considerations related to surgical management and types of attachments have been discussed. In the orthodontic management of impacted canines the clinician has to make certain decisions regarding one-arch vs. two-arch treatment and canine vs. first premolar extraction. The factors which might influence such decisions were also discussed.


Age changes in the human frontozygomatic suture from 20 to 95 years. The frontozygomatic suture of human cadaver material was examined by a combination of histologic, radiographic, and gross tecniques to determine the aging changes in the suture and the approximate age at which sutural fusion occurs. The sample consisted of sixty-One specimens of human beings ranging in age from 20 to 95 years.  Observations were made on specimens at age intervals of 5 years.  Since the frontozygomatic suture is bilateral, one suture from each specimens was used for radiographic and gross examination for synostosis, and the opposite side was subjected to histologic analysis.  The findings of this study have lead to the following conclusions:  1.  The human frontozygomatic suture undergoes synostosis during the eigth decade of life, but does not completely fuse by the age of 95 years.  2.  Synostosis is a progressive process which commences as small areas of bony union that occur initially within the internal portion of the suture and then progresses to the orbital perisosteal surface.  Bony union is not found at or near the facial periosteal surface.  3.  The bony surfaces of the frontozygomatic suture become increasingly irregular with advancing age as a result of the formation of projections or interifitations=


An evaluation of extraoral combined high-pull traction and cervical traction to the maxilla. The effects of extraoral combined high-pull traction and cervical traction of known duration (mean, 122 days) and magnitude (2.5 to 3 pounds total per side) were studied by means of serial lateral cephalometric head films of thirty patients. The lateral cephalometric head films used were taken at three different times: before the extraoral force was applied, after the prescribed period of continuous headgear wear, and as long as possible after the extraoral force was discontinued. Changes in the dentition and associated structures were described both for the period of continuous headgear wear and for an average of 3.2 years later. The following conclusions are based on statistical analysis of the observed changes: 1. The position of the maxilla and the palatal plane was not significantly affected by relatively short periods of extraoral combined high-pull traction and cervical traction to the maxillary first molars as used for this investigation. 2. The maxillary first molars can be moved distally and bodily with this appliance without extrusion. 3. On the average, the mandibular first molars uprighted distally in response to the extraoral force to the maxilla. 4. The maxillary and mandibular first molars demonstrated a strong tendency to recover to their original positions and inclinations relative to their respective bases during the posttreatment period. 5. The amount and direction of growth in the posttreatment period may be important in determining how the Class I relationship is maintained.


Membership participation in AAO reference committee hearing.


The cephalometric distinction of class II, division 2 malocclusion. Forty-two cases of Class II, Division 2 malocclusions were selected on the basis of Strang's first six steps. There were nineteen male and twenty-three female patients in the study. The average age was 12.5 years. These cases were compared with the normal sample of the Alabama Analysis. The Class II, Division 2 sample was compared to a sample of fifty-seven Class II, Division 1 cases. Means, standard deviations, and analyses of covariance, adjusted for age and sex, were derived. Illustrations show, numerically and graphically, the similarities and differences between Class II, Division 2 malocclusions and normal occlusions. Fig. 4 shows the comparison between the Class II, Division 1 and the Class II, Division 2 typical profiles.


Intraprofessional cooperation, or competition.


Case report. The nonspecific rheumatoid subcutaneous nodule: its presence in fibrositis and scleroderma. "Rheumatoid" subcutaneous nodules that were at one time considered diagnostic of rheumatoid arthritis or rheumatic fever have also been found in individuals withoug known disease, in patients with systemic lupus erythematosus, and in other conditions. In this report, subcutaneous nodules were described in one patient with fibrositis and in another scleroderma. Multiple pathogenic mechanisms are probably responsible for development of these nodules.


Major first arch malformations; contrasting causes and the clinical consequences.


Gingival repair potential.

Gingival repair potential.


The biological basis for cryosurgery of oral lesions.


The future of psychotherapy: fiscal and legal issues.


The psychology of the dying patient.

The psychology of the dying patient.


Valium.

Valium.


Membrane excitation through voltage-induced aggregation of channel precursors. Electrically excitable lipid bilayers show the same voltage-dependent kinetics as nerve and other excitable cells. In the bilayers the gating process involves the voltage-dependent insertion of channel-forming molecules into the hydrocarbon region and their subsequent aggregation by lateral diffusion into an open "barrel stave channel." This process can account quantitatively for the classical Hodgkin-Huxley kinetics including inactivation as well as for certain kinetic features that lie outside the Hodgkin-Huxley domain. The multi- and single-channel kinetics suggest that both the insertion and the aggregation reate constants are voltage-dependent, and it is argued that a voltage-induced lateral phase separation between the lipids and the channel-forming molecules increases the local concentration of channel precursors and their aggregation rates. Because the observed aggregation rates are faster than those calculated from an upper limit of the diffusion constants and the known average concentration in the lipid phase, it is likely that the channel-formers preaggregate at the membrane surface. The structural characteristics of the channel-formers and the evidence supporting a similar excitation mechanism in nerve are discussed.


Ion-membrane interactions as structural forces.


Arterial blood gas analysis and its relation to metabolism and respiratory physiology.


Re-evaluation of rapid induction (surge technic) of I.V. barbiturates.


Purification of acetylcholine receptor from Torpedo californica and its incorporation into phospholipid vesicles.


Accidental intra-arterial injection: a medical emergency.


Currents associated with the ionic gating structures in nerve membrane.


Six month sedation course.

Six month sedation course.


"Sandwich" complexation in cyclopeptides and its implications in membrane processes.


Sweetening the beats gone sour.

Sweetening the beats gone sour.


Mechanism for channel gating in excitable bilayers.


Drugs and equipment recommended for the anesthesia cart.


A.S.A. approves program.

A.S.A. approves program.


A versatile accessory for stationing corrugated rebreather tubes during surgery.


The kinetic and equilibrium components of selective ionic permeability mediated by nactin- and valinomycin-type carriers having systematically varied degrees of methylation.


Biological applications of ionophores: theory and practice.


The interaction of hemocyanin and lymphocytes with lipid bilayer membranes.


The lipid bilayer membrane as an assay for ion-conductance-inducing materials isolated from biological membranes.


INtestinal sugar transport: studies with isolated plasma membranes. The luminal and the contraluminal plasma membranes of small intestinal epithelial cells were isolated separately and in the form of membrane vesciles. In the luminal membrane distinct transport systems exist for D-fructose and for D-glucose and glucalogs as evidenced by stereospecificity for the substrate, counter- and cotransport phenomena, and inhibitor specificity. D-Glucose is taken up against a concentration gradient when energy is supplied in the form of an electrochemical Na+ gradient between medium and intravesicular membrane space. The contraluminal membrane also possesses a glucose transport system. However, it is sensitive to different inhibitors than the glucose transport in the luminal membrane. D-Glucose uptake by the contraluminal membrane is not enhanced by Na+ gradients and can be characterized as "facilitated diffusion." The studies with the isolated plasma membranes allow a description of transcellular D-glucose transport in terms of the translocation events across single membranes.


Driving forces of amino acid transport in animal cells. Our observations on the response of TPP+ uptake into K+-depleted cells on the extracellular K+ concentration and on the addition of ouabain and amino acid appear to provide suggestive evidence of, or are at least consistent with, the operation of a powerful, K+-activated electrogenic pump. They are also consistent with the assumption that in these K+-depleted cells the active uptake of amino acid energized by the electric PD presumably generated by this electrogenic pump. It follows that an energy source other than the electrochemical potential gradient of Na+ ions need not be invoked to explain active amino acid transport with inverted Na+ and K+ distribution. In the presence of an electrogenic cation pump one should expect that owing to the activity of this pump the electrical PD is raised under these conditions to a value outweighing the opposed chemical potential gradient of Na+. The experimental evidence so far available is clearly consistent with such an assumption.


Isolation, properties, and structural features of divalent cation ionophores derived from beef heart mitochondria. The notion of small molecular weight ion carriers in biological systems is herein documented by a description of the isolation and ionophoretic properties of a family of oxyoctadecadienoate congeners derived from beef-heart mitochondria. Although certain members of this family of compounds have been shown to possess unique ionophoretic properties, one should not lose sight of the fact that the compounds that we have described represented only a portion of the total picture. Other chemically unrelated, yet structurally unknown species have been isolated from beef-heart mitochondria, and compounds similar in both chromatographic and spectroscopic properties to the oxyoctadecadienoate family, as well as other unique structures, have been isolated in our laboratory from sarcoplasmic reticulum and chloroplasts. The important points to be derived from these findings are that there is an apparent abundance of natural ionophores and we should no longer concern should address ourselves to the more relevant task of digging them out and ourselves with the question "are there ionophores in biological systems?" but describing their chemical and physical properties. In view of the apparent abundance of natural ionophores, this is an enormous task, especially when one considers that it only represents half of the problem. The isolation and description of the ionophoroprotein or channel-forming complexes share equally in the overall significance and level of understanding attributable to this area of inquiry and it would appear that many fruitful collaborative ventures are, or should be, on the horizon.


Epidemiology of respiratory infection in the intensive care unit.


Myelomonocytic leukaemia following cyclophosphamide therapy of rheumatoid disease. A 69-year-old woman treated for 31 months with daily oral cyclophosphamide for refractory rheumatoid disease developed acute myelomonocytic leukemia 21/2 years after stopping the drug. The possibility of a casual association between the therapy and subsequent leukaemia is supported by the growing experience with cytotoxic agents.


Aleukemic leukemia cutis.

Aleukemic leukemia cutis. Specific leukemic cutaneous infiltrates preceded observable leukemic cells in the blood in a case of acute lymphoblastic leukemia. Examination of a cutaneous biopsy specimen led to early diagnosis of the disease.


Oral surgery in general dental practice. Assessment of lower third molars. Methods of pre-operative assessment of impacted lower third molar teeth are discussed and the main diagnostic features are stressed in order to ensure that the pracitioner fully comprehends the nature and difficulty of the procedure.


Teeth and infective endocarditis.

Teeth and infective endocarditis. Despite a lack of certain knowledge regarding the role of the teeth in the aetiology of endocarditis, antibiotic prophylaxis should be given before gingival blood vessels are opened in cases of rheumatic heart disease. Much higher doses are required in patients with prosthetic heart valves. Full clearance of the teeth should be considered when a patient has already had an attack of endocarditis or where a prosthetic heart valve has been placed. Strict oral health is required in patients at risk.


An adhesive paint-on restorative for tooth surface defects. The physical properties of an adhesive paint-on restorative material have been examined and it is shown that the adhesion to enamel is good, its compressive strength about equal to silicate, hardness is less than for composite resins, and stain resistance is good.


Odontogenic cystic lesions of the jaws.

Odontogenic cystic lesions of the jaws. In a period of ten years 64 patients with odontogenic cystic lesions were found in 80,408 patients attending the Dental Out-Patient Department, All India Institute of Medical Sciences Hospital, New Delhi. Two-thirds of the lesions were found in male patients and no neoplastic lesion was recorded in the maxilla. There were more periodontal cysts in the maxillary than in the mandibular incisor region. The majority of lesions were found in age groups 10-40 years.


Chronic granulocytic leukemia. Review of 536 cases. The Western Cancer Study Group (WCSG) retrospectively reviewed chronic granulocytic leukemia (CGL) diagnosed during 1960 to 1974 from 22 institutions. In 100 cases, patients had positive findings for the Philadelphia chromosome (Ph'+). In 426 cases karyotyping was not done (Ph'?). Ten patients had no Ph' chromosome (Ph'-). The ten Ph'- patients ranged in age from 8 to 85 years and in survival from 1 to more than 125 months. Their small number and heterogeneity precluded statistical analysis, but this notable heterogeneity of the Ph'- group may well be typical. Busulfan prolonged survival in the Ph'+ and Ph'? patients. Females and younger patients tolerated their disease better than males and older patients. Survival studies without reference to the Ph' status, treatment, age at diagnosis, and sex are probably not valid.


Metallographic changes and phase identification in a nickel base alloy upon fusion and casting. Three groups of tensile test pieces were produced using a nickel base partial denture castin alloy and employing induction fusion in each case. The first group was produced from new metal, the second from metal which had been recast four times, and the third from new overheated metal. Samples of alloy were cut from each group and, together with a piece from an original ingot, were mounted, polished, etched, and examined under a metallurgical microscope in order to determine the nature and extent of the metallographic changes resulting from fusion and casting of the alloy.


Editorial: Australian Dental Plans.

Editorial: Australian Dental Plans.


The oral health of a group of dental students. The oral health of sixty-two dental students was examined over an interval of two or three years. The results were recorded and certain conclusions reached.


Darwin dental survey--1972.

Darwin dental survey--1972. An examination limited to the recording of dental caries, periodontal disease and oral hygiene of 1592 children aged 3-14 years resident in Darwin, Northern Territory of Australia was made in August, 1972. Ther survey provides base-line data for future assessment of the value of fluoridation. Forty-two per cent of the children had received regular fluoride supplements and dental caries prevalence was lower than expected for a non-fluoridated Australian community.


Letter: Is that apicoectomy really necessary?


Coping behaviour: correlates of survival on a raft. The seven survivors of a shipwreck, involving ten men, were interviewed within a few days of rescue. They had been floating in a rubber raft for 9 days and had thereafter been on an isolated rocky beach for four days. Three of the men walked through dense bush to obtain help. Rescue came on the thirteenth day. The purpose of the authors' examination was to identify those behaviours which the survivors reported as helping them to cope during their ordeal. The most prominent of these were attachment ideation, drive to survive, modelling, prayer and hope. Attachment behaviour is described in some detail as a most potent, but inadequately recognised coping behaviour.


Merphos poisoning or mass panic?

Merphos poisoning or mass panic?


Abandoning the mentally ill.

Abandoning the mentally ill. Mentally ill people have been avoided and abandoned by their families and public authorities for hundreds of years. Present day abandonment includes the deployment of professionals from patients to paper; the destruction of availability and effectiveness of institutional facilities; the obfuscation of mental illness by captious, sematic criticism; the aspirations of paramedical and paraprofessional groups; and the subordination of the primary purpose of institutions and physicians to other objectives. The nature of authority is discussed and the need for the treatment of mentally ill people to be based on the art and science of medicine, rather than the pretension and advocacy of the gullible, unqualified or unscrupulous, is noted.


A clinical trial of the efficacy of a cetylpyridinium chloride-based mouthwash 1. Effect on plaque accumulation and gingival condition. A commercially avaiblable mouthwash, containing 0.05 per cent w/v cetylpyridinium chloride, reduced dental plaque accumulation by 30 per cent in a clinical trial when used briefly, three times a day, after meals.


Letter: The use of high-fructose corn syrup as a sweetener.


Changing patterns of psychiatric hospitalization in past fifty years: a cohort study. Nine cohorts of patients admitted between 1919 and 1962 have been followed up until 1971. Comparison has been made in terms of sex and age specific incidences of selected psychiatric disorders throughout the whole period. The results of treatment have been evaluated in terms of discharge and death rates, length of stay, re-admission rates to psychiatric institutions and total period under hospitalization. These data have been compared with those available since the introduction of the statistical system in Victoria in 1961.


Plasma nortriptyline and clinical response.


Suicidal attempts in an outer region of metropolitan Melbourne and in a provincial region of Victoria. A two year study of attempted suicide was undertaken in two Victorian regions. Incidence rates of 16.7 and 22.1 per 10,000 population were found in the metropolitan and provincial regions respectively. A number of factors were considered and found relevant to the difference in incidence. In addition, other parameters including multiple attempts, seasonal distribution, method used, association with alcohol and referral to psychiatric care were considered. Our findings are compared with those of earlier studies reported in Australia.


Foreign language interpreting in psychiatric practice. This article examines the problems of foreign language interpreting in psychiatric practice. It is demonstrated how an interpreter's apparent competence may readily be mistaken for true competence and that it is well worthwhile formally assessing an interpreter's command of his second language. In interpreting from patient to psychiatrist, the omission of important material was found to be a noteworthy feature. Here the meaninglessness of material not only favoured its omission but also often indicated important psychopathology. It was found that the more psychotic the patient the more likely it was that mistakes in interpreting from patient to doctor would occur.


Letter: Schizophrenic symptomatology.

Letter: Schizophrenic symptomatology.


Juvenile delinquent drug abuse in females: a clinical study. Thirty drug taking and thirty non-drug taking delinquent adolescent girls were assessed using a psychiatric interview technique. Differences were observed between the groups on an aggressive-passive-withdrawn dimension. Drug takers were found to be passive and withdrawn whilst control group subjects were found to be more aggressive. These factors were identified within the modal personality of the delinquent girl. The results supported M.M.P.I. studies of the drug taking personality and were seen as an indication of aetiology and its implications for assessment and treatment.


Attempted suicide in the Perth Statistical Division 1971-1972. A study of attempted suicides in the Perth Statistical Division for 1971-72 has been presented. The average annual rate was 8.5 per 10,000 for males and 20.3 for females. There had been a doubling in rate since 1961, the increase being greater for females than males. Age standardised rates were greater than the Australian born for immigrant males but not for females. There were marked differences in rates between different individual immigrant groups of each sex. Data presented showed a higher rate in aborigines compared with non-aborigines, but many reservations were made regarding the validity of the aboriginal rates.


Neurosurgery from a practical viewpoint.


Is monocular testing in presbyopes useful?


Poisoning in children.

Poisoning in children.


Nursing: a profession struggling to define itself.


Editorial: A new board.

Editorial: A new board.


Surface roughness of restorations.

Surface roughness of restorations.


Median cleft lip with dental arch and palate duplication. A case report.


Editorial: Ethics.

Editorial: Ethics.


Acute arthritis caused by Aeromonas hydrophola: clinical and therapeutic aspects. Two cases of Aeromonas hydrophila arthritis are reported and a third case present in the literature is reviewed. All three cases occurred in patients with myelogenous leukemia; the knee joint was involved in 2 patients and the metacarpal-phalangeal joint in the third. In the 2 patients presented here, synovial fluid antibiotic levels were measured and were adequate; but A hydrophila was repeatedly cultured from the knee joints, a fact suggesting that other factors, such as normal functioning leukocytes and specific opsonizing antibody against the organism, are also necessary to kill A hydrophila.


Cervicofacial actinomycosis: in the presence of mandibular bone loss.


Bacterial contamination and the exposed pulp.


The analgesia and innervation of mandibular teeth.


Lipoma of lip with cartilage formation.

Lipoma of lip with cartilage formation.


Opening of Walton Postgraduate Medical Centre.


Mental dental equipment.

Mental dental equipment.


Editorial: Dental health education.

Editorial: Dental health education.


Root aplasia following maxillary sinus irrigation. Case reports.


Report of the Representative Board to the annual general meeting of members, 1976.


The Klippel-Feil syndrome. A rare cause of cervico-facial deformity.


Proceedings: A double lung ventilator for experimental use.


Public attitudes towards alcoholism in a Scottish city.


The alcohol advertising ban in British Columbia: problems and effects on beverage consumption.


Production, consumption and recent changes of consumption of alcoholic beverages. Part I. The production and consumption of alcoholic beverages.


A monitoring and evaluation plan for alcoholism programs.


Alcoholism treatment in Trinidad.

Alcoholism treatment in Trinidad.


Young drug and alcohol casualties compared: review of 100 patients at a Scottish psychiatric hospital.


British users of opiate-type drugs: a follow-up study.


Abuse of stimulant drugs in Nigeria.

Abuse of stimulant drugs in Nigeria.


Alcoholic day treatment unit Herbert Day Hospital, Bournemouth.


Movement of heroin addicts between drug treatment programs.


Prevalence of self-reported drug use among London undergraduates.


Annotation: Subacute and chronic myelomonocytic leukaemia: a distinct haematological entity.


Manipulation of the mitotic cycle in the treatment of acute myelogenous leukaemia. A priming dose of cytosine arabinoside (Ara C) was given to 16 children and five adults with acute myelogenous leukaemia (AML) to synchronize leukaemia cells in the DNA synthesis (S) phase of the mitotic cycle. An infusion of this drug, which was continued for 12 h, was started at the time of partial synchronization and was repeated every 6-12 h until the bone marrow was very hypocellular. Complete remission was achieved in 12 of 16 children and in all adults. Two of the four children went into complete remission with the addition of two doses of daunorubicin or adriamycin. These results suggest that partial synchronization of cells in the S phase results in a therapeutic advanatage in the use of Ara C for induction of a remission of AML and that manipulation of the mitotic cycle, as monitored by kinetic studies, may be helpful in planning optimal schedules for drug administration.


Cell-mediated cytotoxicity as a result of immunotherapy in patients with acute myeloid leukaemia. Leucocytes from normal individuals and from patients with acute myeloid leukaemia (AML) in remission receiving active immunotherapy with allogeneic AML blasts (AML-I) were cultured for 6 days with AML-I blasts, Burkitt's lymphoma cells (BL) or lymphoblastoid cells (LCL). The leucocytes were then tested for cell-mediated cytotoxicity (CMC) against 51Cr-labelled AML-I, BL or LCL target cells. There was no substantial difference in the CMC of leucocytes from patients and normals cultured without stimulation, and tested against AML-I, BL or LCL targets. Patient's leucocytes stimulated in vitro with AML-I had a greater frequency of positive CMC responses against AML-I, BL and LCL than normal individuals. The results suggest that co-cultivation of leucocytes with AML-I blasts reactivates memory cytotoxic leucocytes in AML patients receiving immunotherapy and that this test may be useful in measuring the effectiveness of immunotherapy.


A clinico-pathological comparison of the amelo-blastoma with the calcifying odontogenic cyst.


Factors that influence haematological remission duration in acute lymphocytic leukaemia.


The calcifying epithelial odontogenic tumour-- report of four cases; two with long-term follow-up. Four cases of calcifying epithelial odontogenic tumour are reported, all with pain as a presenting symptom. Two of the cases have long-term follow-up, one with a recurrence after 16 years and the other with no recurrence after 24 years. Only 17 per cent of cases reported in the literature have follow-up of 10 years or more, and yet the possibility of recurrence after this length of time must be considered. Recommendations for treatment are made based on the biological behaviour and recurrence rate following various types of treatment reported in the literature. It is recommended that patients in whom the diagnosis of calcifying epithelial odontogenic tumour has been made should be reviewed continuously.


The benign cementoblastoma--just how benign?


Pycnodysostosis--a rare disorder complicating extraction.


Solitary bone cyst of the mandible--report of a case.


Osteomyelitis of the jaws as a sequel to dental local anaesthetic injections.


Cervico-facial infection with mycobacterium chelonei--a case report.


Reddening of the upper central incisors associated with periapical granuloma in lepromatous leprosy. Four years after starting treatment for lepromatous leprosy in England a male Pakistani aged 26 was found to have red discoloration of the upper central incisor teeth. A radiograph suggested periapical abscess on the right with haziness in a corresponding area on the left. Right apicectomy was performed with removal of a solid mass attached to the apex, sections revealing a lepromatous infiltrate with acid-fast fragments of Mycobacterium leprae in the cytoplasm of foamy macrophages. Clinical and archaeological evidence for the frequent involvement of these teeth in lepromatous leprosy is reviewed. The upper incisor area is relatively cool, a factor which may be of critical importance for the lodgement and multiplication of this bacillus, as it is in other body sites in lepromatous leprosy.


Adverse reactions to carbamazepine (tegretol). A review of the literature on adverse reactions to carbamazepine used in treatment of paroxysmal trigeminal neuralgia is presented and a survey of 120 cases is reported. The case reports were selected to emphasise some of the adverse reactions to carbamazepine. The blood picture was monitored every month while patients were on carbamazepine therapy. As with any medication, side-effects and complications may occur. When a patient shows a minor intolerance to the drug, the dose should be reduced to the one that controls the symptoms incompletely but produces no adverse effects. As the patient acquires greater tolerance the dosage may be gradually increased. Periodic monitoring of the blood picture and of liver and kidney function is important.


Effects of nitrosoureas on human DNA polymerase activities from acute and chronic granulocytic leukemia cells. In vitro DNA synthesis by isolated cytoplasmic DNA polymerases of human leukemic cells was found to be inhibited by 1,3-bis(2-chloroethyl)-1-nitrosourea, 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea and 1-(2-chloroethyl)-3-(trans-4-methyl-cyclohexyl)-1-nitrosourea. 2-Chloroethyl isocyanate and cyclohexyl isocyanate, the decomposition products of 1,3-bis(2-chloroethyl)-1-nitrosourea and 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea, respectively, are as effective as their parent nitrosoureas in inhibiting the enzyme activity. Preincubation studies indicated that these compounds inhibit DNA synthesis primarily by altering the enzyme DNA polymerases without significantly affecting the DNA template activities.


Preliminary results of an immunotherapy trial on terminal leukaemic lymphosarcoma. 42 patients suffering from terminal leukaemic lymphosarcoma were treated as acute lymphoid leukaemia patients. 26 entered apparently complete remission (CR). They were submitted to complementary cell reducing treatment comprising systemic and intrathecal chemotherapy and radiotherapy on the CNS and on the lymphosarcomatous masses that had been detected at the beginning of leukaemic conversion. Eight relapsed during this treatment and 18 were still in CR at the end of it: nine were submitted to active immunotherapy (BCG + C. granulosum + irradiated allogeneic leukaemic lymphosarcoma cells): five out of the nine have remained free of disease for between 13 to 66 months. Nine served as controls: all except two, who are still at the beginning of the trial, have already died from leukaemic manifestations.


The influence of diagnostic and remission leukemic sera on normal lymphocyte transformation. The influence of acute lymphoblastic leukemic serum on normal lymphocyte transformation was studied using four different blastogenic stimulants, pokeweed mitogen (PWM), phytohemagglutinin (PHA), Concanavalin-A (Con-A), and mytomycin-treated allogeneic lymphocytes. Marked inhibition of lymphocyte transformation was observed in all leukemic sera tested (15/15) when PHA was used to induce transformation. Inhibition of lymphocyte transformation induced by Con-A, PWM and allogeneic cells was observed in 6 of 15, 4 of 15 and 5 of 15 sera respectively. A series of studies with PHA-induced transformation demonstrated that the observed inhibitory activity of sera collected at the time of diagnosis was not present in sera collected during complete remission states. However, serial studies in four patients from the time of diagnosis throughout complete remission to relapse of acute leukemia were inconclusive with regard to the significance of inhibitors as prognostic indicators. Preliminary evidence is presented which indicates that the observed inhibition is not completely accounted for by alpha-globulin concentrations.


Premature chromosome condensation in human leukemia. Premature chromosome condensation (PCC) has previously been observed in tissue culture and is believed to arise from asynchronous mitotic activity in multinucleated cells in which the affected nucleus is in interphase and at least one nucleus is in metaphase. Such cells have been noted following fusion induced by virus infection, spontaneously, and after treatment with cytochalasin B. The phenomenon has also been observed in malignant pleural effusions, but has not previously been described as a feature of hematologic disease. In this study, we report the observations of PCC in seven patients. Six of these patients had either acute myeloblastic leukemia or acute myelomonoblastic leukemia in association with the features of erythroleukemia, i.e., leukoerythroblastic reaction in the blood, and erythroid multinuclearity, "megaloblastoid" changes, and PAS-positive staining of erythroid precursor cells in the bone marrow. In all patients, erythroid multinuclearity has been noted. However, not all patients with erythroleukemia exhibit PCC. In this series, three additional patients have had similar bone marrow morphologic changes without PCC. The finding of PCC in erythroleukemia may have important implications as to etiology of this disorder.


Hypodiploidy and cellular survival.

Hypodiploidy and cellular survival. Cytogenetic study of bone marrow cells in a child with acute lymphocytic leukemia showed a 27 chromosomes cell-line. Only four pairs appeared to be normal (X, 10, 18, 21). All the others were haploid. This strong hypodiploidy seems to be compatible with the survival and proliferation of these abnormal cells.


Trisomy 8 in the bone marrow associated with high red cell glutathione reductase activity. In a series of 841 patients with hematologic disorders, 10 individuals were found to have an extra C group chromosome in their bone marrow cells. In two the extra chromosome was not identified, but in the remaining eight it was No. 8. Four of these ten patients had leukemia, and the others had cytopenias or other probably preleukemic conditions. The mean value for glutathione reductase activity in the red cells of four patients with trisomy 8 was significantly higher (2980 +/- 940 mumoles/min/liter of erythrocytes) than in normal controls (1930 +/- 360) or in any of five different control groups of patients with hematologic disorders. The extent of enzyme activation as a result of preincubation with exogenous flavin adenine dinucleotide was similar in the erythrocytes of all groups. The reasons for the high values of red cell glutathione reductase activity in patients with trisomy 8 are discussed in the light of the proposed assignment of the gene for that enzyme to chromosome 8.


Cyclophosphamide-asparaginase- vincristine-prednisone induction therapy in childhood acute lymphocytic and nonlymphocytic leukemia. A remission-induction regimen for childhood leukemia using cyclophosphamide, asparaginase, vincristine, and prednisone (CAVP) was compared to standard vincristine-prednisone (VP) induction. The more intensive regimen was associated with a lower complete remission rate (81% vs 93%) and a higher early death rate from infection (15% vs 5%) for acute lymphocytic leukemia. In contrast, complete remission was achieved in 58% of children with acute nonlymphocytic leukemia treated with CAVP compared to 18% for VP. Early death rates were similar (27% vs 25%). These observations corroborate previous studies in childhood nonlymphocytic leukemia showing activity for asparaginase. Preliminary analysis of remission duration and survival for responders shows no advantage for those who survived the more intensive induction.


The ultrastructure of osteosarcoma. A review of twenty cases. The ultrastructural features of 20 cases of osteosarcoma are discussed. Characteristically, the malignant cells (osteoblasts) contained large quantities of dilated, anastomosing rough endoplasmic reticulum, ofter forming large lakes. Mitochondria were sparse. Similar features are seen in osteoblasts in normal developing bone. Marked ultrastructural similarities of cells from chondrosarcomatous, fibrosarcomatous and typical osteosarcomatous areas of these tumors strongly supports the concept that these neoplastic cells all arise from the same progenitor cell. Malignant giant cells were readily differentiated from benign osteoclasts. The most significant ultrastructural findings were the varying degrees of calcification in the intercellular areas (osteoid), ranging from an extensive dense deposition of hydroxyapatite crystals which obscured the underlying collagen fibers, to focal collectors, or puffs, of slender needle-shaped hydroxyapatite crystals deposited on or along collagen fibers. The earliest apparent evidence of calcification was the presence of small electron-dense particles on or in collagen fibers.


The heterogeneity of leukemic reticuloendotheliosis, "hairy cell leukemia". Evidence for its monocytic origin. The presence of B, T, and monocyte markers were studied on the spleen and peripheral blood mononuclear cells from two patients with leukemic reticuloendotheliosis. A high proportion of cells from both patients bore a receptor for cytophilic antibody, both in suspension and frozen tissue section. Cells in suspension lacked surface immunoglobulins or a receptor for sheep red blood cells. These results favor the evidence that "hairy cells" are monocytic in origin.


Multiple myeloma, acute leukemia, and Hodgkin's disease. Occurrence in three of four family members. Among a family of four persons, three members each had a separate malignant disease during a 3-year period. The mother and father concurrently had multiple myeloma and Hodgkin's disease, respectively, and less than 3 years later, their only son was found to have acute granulocytic leukemia. No increased incidence of deaths attributed to Hodgkin's disease, acute leukemia, or multiple myeloma was found in the community. No other cause for this cluster of hematologic malignancies could be found.


Acute lymphoblastic leukemia in adults and children. Differences in response with similar therapeutic regimens. Twenty-three adult patients (ages greater than 15 years) and 75 children with acute lymphoblastic leukemia were treated with similar intensive, sequential cytotoxic protocols (L-2). The adult patients have lower remission rate (78%) than the children (98%). The duration of remission and the length of survival are also shorter in adults. The incidence of central nervous system (CNS) relapse in adults (27.7%) is higher than in children (7.1%) suggesting that prolonged prophylactic intrathecal methotrexate as given to the children is more effective than the schedule used for adults where intrathecal methotrexate was given only in the first 2 months of therapy. The low incidence of CNS involvement in children on the L-2 protocol compares favorably with other series reported using a combination of cranial irradiation and intrathecal methotrexate. In both adults and children there seemed to be a higher incidence of CNS involvement in patients with initial white blood cell counts greater than 25,000 cells/mm3.


Recurrent childhood lymphocytic leukemia following cessation of therapy: treatment and response. A unique population of patients--children who developed recurrent acute lymphocytic leukemia (ALL) following cessation of initial prolonged therapy--was studied. During a 2-year period, 17 such children were admitted to a planned combination chemotherapy program. Complete bone-marrow remissions were achieved in 16 patients, and the median duration of second hematologic remissions was 216 days. These responses were significantly better than those obtained in seven patients who relapsed during the administration of continuation chemotherapy. Although the rate and duration of induced remissions were notably high, 9 of the 17 patients who relapsed off therapy have again developed recurrent leukemia. This result, together with the moderate toxicity encountered during treatment, indicates that more therapy is needed. The equal proportion of bone marrow and meningeal relapses was interpreted to mean that a secon course of preventive central nervous system therapy early in remission may be especially useful.


Granulocytic sarcoma: local presentation of a systemic disease. The case of a pregnant woman with a breast mass that proved to be a granulocytic sarcoma is presented. Her systemic therapy was initiated at a time when her tumor burden was possibly relatively low and a good response to the aggressive combination chemotherapy including Daunomycin was obtained. She was successfully carried through pregnancy and delivered a normal child despite combination chemotherapy. Factors relating to her case have been reviewed in the literature.


Chromosomal mosaicism associated with prolonged remission in chronic myelogenous leukemia. The nature of the relationship between normal stem cells and the leukemic cells of chronic myelogenous leukemia (CML) is of considerable theoretical and practical importance. We studied a patient with CML who has maintained a complete hematologic remission for eight years without therapy. Presently, the only documentable abnormality is mosaicism for the Philadelphia (Ph1) chromosome. Studies of his bone marrow in vitro revealed normal colony formation in agar and normal cellular proliferation and differentiation in liquid culture. Observations in this patient indicate that a Ph1-positive clone may coexist with normal stem cells during prolonged remission in CML and the Ph1-positive cells may not always have a growth advantage over normal cells. The culture studies further suggest that the diminished proliferative capacity of the leukemic cells was not due to in vivo host suppressive factors.


Pseudomalignant osteoblastoma versus arrested osteosarcoma: a case report. A case is presented which is interpreted as a histologically pseudomalignant osteoblastoma. This diagnosis is supported by the clinical and radiologic findings. Arguments are presented in support of this diagnosis as against an osteogenic sarcoma with an arrest in growth, although this latter diagnosis cannot be completely excluded.


C-G translocation in acute myelocytic leukemia with low neutrophil alkaline phosphatase activity. A consistent chromosome abnormality of C-G translocation, t(8;21)(q22;q22), was found in 15 acute myelocytic leukemia (AML) patients with low neutrophil alkaline phosphatase (N-AP) activity. Granulocytes of these patients also had specific morphologic abnormalities. The bone marrow showed a tendency to relatively good maturation of leukemic cells for the disease AML. Clinical courses of the patients were mild and median survival was longer than that of patients with normal or high N-AP activity (p = 0.065, suggestive difference). Three out of six male patients with these type of AML had missing Y chromosome in addition to C-G translocation. The results suggest that specific cytogenetic abnormality of C-G translocation would be significantly associated with AML. Contrasting with low N-AP activity and the Philadelphia chromosome in chronic myelocytic leukemia, the findings in AML may offer additional evidence towards the possible relations between alkaline phosphatase activity and C or G chromosome.


Periosteal osteogenic sarcoma.

Periosteal osteogenic sarcoma. A study of 102 osteogenic sarcomas of the bone surface revealed that 79 were parosteal osteogenic sarcomas. Roentgenographically, these 79 were dense, lobulated lesions attached by a broad base to underlying bone, usually the lower femoral shaft. Histologically, they were low-grade osteosarcomas. The other 23 lesions (periosteal osteogenic sarcoma) usually involved the upper tibial shaft and presented as small radiolucent lesions on the surface, with formation of spicules of bone perpendicular to the bone shaft. Histologically, these 23 were relatively high-grade, predominantly chondroblastic osteogenic sarcomas. Thirteen of the 23 patients were males, and most were in the second decade of life. Of five patients who had excision of the tumor, two had recurrence. Seven of 13 patients who underwent amputation initially were alive without disease at last follow-up. Only 4 of the 23 patients have dies of metastatic disease.


Parosteal osteogenic sarcoma.

Parosteal osteogenic sarcoma. A clinicopathologic study of 79 patients with parosteal osteogenic sarcoma revealed that more females than males were affected and that most of the patients were in the second to the fourth decades of life. Sixty-eight percent of the patients had involvement of the posterior aspect of the lower femoral shaft. The roentgenogram characteristically showed a large, dense lobulated mass attached by a broad base to the underlying bone but with no involvement of bone itself. Microscopically, the tumor presented as well-formed bands of osteoid within a hypocellular spindle cell stroma. Seven of the lesions had foci of high-grade osteogenic sarcoma within an otherwise typical parosteal osteogenic sarcoma. Six of the 79 lesions showed involvement of the medullary cavity at surgery. Thirty-one patients had excision as their initial treatment; four of the 31 required nv further therapy. Ten patients had resection initially; three of the ten had recurrence. Only four of 27 patients who underwent amputation initially developed pulmonary metastasis. The presence of histologically "active" tumor and medullary involvement seemed to affect the prognosis adversely. Our data indicate that complete radical removal of the tumor is the treatment of choice, with resection when feasible and amputation when necessary.


Disposition of [3H]actinomycin D in tumor-bearing mice. A single, nonlethal dose of actinomycin D will cause total regression and cure of Ridgway osteogenic sarcoma in mice. A cure is not obtained with a single dose daily for 7 days, a dose regimen which kills 10% of normal C57BL/6 X DBA/2 mice. This suggests that actinomycin D is more effective on a single high-dose schedule than on chronic daily therapy. Analysis of drug exposure in Ridgway osteogenic sarcoma and normal mouse tissues following the single and multiple-dose regimens suggests the difference in therapeutic response is due to drug exposure at a higher concentration in Ridgway osteogenic sarcoma after the single high dose than after the multiple-dose regimen. This may be related to the higher drug concentration attained in blood following the single-dose regimen than is attained with the multidose regimen.


Prognostic value of chromosomal findings in Ph1-positive chronic myelocytic leukemia. Chromosome examinations were performed on bone marrows from 88 patients with Ph1-positive chronic myelocytic leukemia (CML). As a group, Ph1-positive CML patients with some cytogenetically normal cells in the marrow survived much longer than those whithout such cells in their marrow. The survival for patients whose first bone marrow exhibited only metaphases with a Ph1 and other karyotypic abnormalities was significantly shorter than that for patients whose marrow exhibited only metaphases with a Ph1 and an otherwise normal karyotype or patients whose marrow contained both categories of cells. The shorter the interval between the diagnosis of CML and the first chromosome examination, the greater the frequency of karyotypically normal cells in the bone marrow. Karyotypic progression in CML was a common phenomenon, whereas a reversion was very rare. On the basis of the findings obtained, the early diagnosis and treatment of CML are indicated, both possibly being helped by the chromosomal findings in the marrow. Furthermore, a combination of the chromosomal data and the marrow cell differential may serve as an important prognostic index in CML.


Concanavalin A-induced agglutination of human leukemic and lymphoma cells. With a newly developed turbidometric method, concanavalin A was shown to agglutinate normal lymphocytes, lymphoma cells, and leukemic cells from chronic lymphocytic leukemia and from acute myelocytic and lymphocytic leukemia. However, there was a marked difference in the kinetics of this agglutination process. Leukemic blast cells and cells from a patient with convoluted lymphoma agglutinated poorly in this system. Conversely, the degree of agglutination for chronic lymphocytic leukemia cells was greater than that for the blast cells and also slightly greater than that for normal lymphocytes. Cultured cells from a Burkitt's lymphoma (Raji) and from a patient with poorly differentiated lymphoma agglutinated very rapidly with concanavalin A. Prior incubation of all cell types with neuraminidase markedly enhanced the agglutination process similar to that of trypsinization. Thus, these studies illustrate the usefulness of this method in quantitating the kinetics of agglutination of various human neoplastic cell types by concanavalin A.


Treatment of acute lymphocytic leukemia by high-dose intravenous methotrexate. A pharmacokinetic study of methotrexate levels in blood and cerebrospinal fluid was performed in 42 patients who received one or more courses of high-dose methotrexate at 500 mg/sq m infused i.v. over a 24-hr period. Methotrexate level in the lumbar cerebrospinal fluid reached 1.2 x 10(-7) M at 0.5 hr and remained constant at that level for the 1st 24 hr. Similar methotrexate levels were noted in the ventricular fluid obtained through an Ommaya device on three patients with brain tumors treated with high doses of methotrexate. Preliminary clinical results using high-dose methotrexate combined with simultaneous intrathecal methotrexate in 23 children with newly diagnosed acute lymphocytic leukemia indicate that this treatment program is safe to administer and to date appears effective in the prevention of central nervous system leukemia.


Amino acid metabolism of platelets in leukemia. Platelets from patients with acute myelogenous leukemia, both before and after remission induction, were evaluated for their ability to incorporate D-[U-14C]glucose into the four amino acids, glutamine, asparagine, glutamic acid, and aspartic acid. Normal platelets incorporated about 80% of the activity into the amides, glutamine and asparagine, and only 20% into their respective amino acids, glutamic acid and aspartic acid. Platelets from patients with acute myelogenous leukemia in the acute stage showed a reversal of this pattern, which then returned to normal during remission. However, the concentration of amino acids was higher than normal, suggesting that remission platelets behaved like a young cell population. The abnormal pattern of labeling could be interpreted as a defect in the platelet citric acid cycle thereby compromising its energy source.


Phase I-II trial of VM-26 (NSC-122819) in the treatment of children with late-stage leukemia.


Patterned relationships between IgM and blast cells in peripheral blood in a child with acute leukemia. 1. Serum IgM determinations and blast cell counts were performed at regular frequent intervals in a case of acute lymphoblastic leukemia in a child. 2. An inverse relationship tended to exist between the concentration of IgM in serum and blast cells in blood during the course of relapses and remissions. 3. High dosage immunosuppressive chemotherapy caused a marked reduction in serum IgM. 4. A relationship appears to exist between IgM and blast cells which may support the concept that impaired ability to produce antibody to leukemia antigens may be an intrinsic component of this disease.


Nutrition and longevity in experimental animals.


Childhood acute lymphocytic leukemia.

Childhood acute lymphocytic leukemia. Childhood ALL is a potentially curable disease. All children suffering from this ailment should be given an opportunity to live by receiving therapy aimed at permanent cure. The disease requires extensive, complex, and costly diagnostic study and treatment. Specialized care is more efficiently given in centers dedicated to treating patients with malignant diseases. The referring physicians are an essential part of the working team delivering care to the children with acute leukemia. Despite improved results, a significant number of patients fail to develop permanent remission. The risk of relapse after cessation of therapy is greatest in the first year and in patients given no specific CNS therapy. However, modern therapy produces a substantial number of long-term leukemia-free survivals in children with ALL, a majority of which persist after cessation of therapy. After cessation of therapy the quality of survival of the vast majority of patients is excellent.


Reactivity of antibody in acute myeloid leukaemia with proliferation-associated nuclear antigen(s). A reaction between antibody in leukaemic sera and nuclear antigen present in leukaemic cells was detected by means of an anticomplement immunofluorescence test. The antibody was found mainly in patients with myeloid leukaemia, particularly those with a high percentage of blast cells in their peripheral blood. The nuclear antigen(s), however, was present in various proportions of the circulating cells of almost all patients with leukaemia, lymphoma or infectious mononucleosis, as well as in phytohaemagglutinin-transformed blasts and proliferating cell lines. Thus, antibody appeared to be detecting a nuclear component associated with cell proliferation.


Increased erythrocytic and neutrophilic progenitors in myelofibrosis with myeloid metaplasia.


Drug antagonism and reversibility of the binding of indoleamines in brain. The specificity of the binding of serotonin to brain preparations was investigated with various competitive agents. A probable relationship between their structure and their capability of displacement was suggested. Bufotenine and morphine displaced serotonin (0.5 X 10(-5) M) binding to synaptic membranes 87 and 49% respectively. Dissociation constants of the binding of 5-HT and tryptamine to synaptic membranes, and displacement constants of certain drugs were determined. The binding of 5-HT and tryptamine to calf brain preparations was also investigated by equilibrium dialysis, in order to determine affinity constants and reversibility of the binding. Differences were noted in the specificity of binding sites for serotonin and tryptamine, suggesting a different binding site for tryptamine. Extrapolations of Scatchard plots were used for determination of the constants. A characteristic low dissociation constant was found for 5-HT in synaptic membranes (K approximately X 10(-6) M). Probably, the binding macromolecule (receptor?) is a proteolipid.


Microbial iron chelates with iron donor properties in hemoglobin-synthesizing cells. Iron incorporation into Friend virus infected leukemic murine spleen cells was studied using the two fungal iron trihydroxamates, fusigen and ferricrocin. Incorporation of 55Fe was measured by isolation of hemoglobin after dimethylsulfoxide-induced hemoglobin synthesis and compared with iron incorporation from 55Fe-labeled ferric citrate.


Effect of arabinosyl cytosine on granulopoietic colony formation by marrow cells from leukemic and non-leukemic patients. This study investigated the arabinosyl cytosine (ara-C) sensitivity of colony formation in culture by human granulopoeitic progenitor cells (CFU-C). Wide variations were observed in the effects of ara-C on CFU-C from the marrow of patients with leukemia in remission after treatment using a chemotherapeutic regimen that included ara-C, or for CFU-C from the marrow of non-leukemic patients. These variations in sensitivity to ara-C could not be attributed to a lack of reproducibility of the culture conditions used, nor to variations in the proliferative state of the CFU-C at the time of exposure to ara-C. No significant correlation was observed between the sensitivity of CFU-C to ara-C and the level of cytidine deaminase in the marrow sample. These results provide some support for the view that cell kill may not be the only basis for the chemotherapeutic effectiveness of ara-C.


New frontiers of ecological ethics--a balance between over- and under-control of outer and inner factors.


New copiers for dental radiograph duplicating film.


Endosteal oral implants. A retrospective radiographic study.


Gastroesophageal involvement in herpes simplex. Herpes simplex in the gastric mucosa has not been previously described. The case presented here describes gastritis and esophagitis resulting from herpes simplex in a patient being treated with immunosuppressive agents. These changes were confirmed endoscopically and radiographically. Biopsy specimens of the gastric and esophageal mucosa showed eosinophilic intranuclear inclusion bodies typical of herpes simplex. The pathogenesis and pathological appearance of herpetic gastritis and esophagitis are presented.


Replacement of tumor-destroyed bone with joint implants.


Cellular dysmaturity as a prognostic index in acute myeloid leukaemia.


Chondroblastic osteosarcoma in the jejunum of a dog.


Electrolyte concentration in the hypertrophic salivary glands of incisor-amputated rats. The effect of periodic amputations of the lower incisors of the rat on the electrolyte concentration in the major salivary glands was studied. The incisor amputations caused a hypertrophy of the parotid, submandibular and sublingual glands. The resulting increased weight of the salivary glands was due to a higher dry mass. In general, the electrolyte concentration showed higher values in the salivary gland tissues of the incisor-amputated animals. Considering the parotid, submandibular and sublingual glands respectively, the Na+ concentration was increased by 47%, 50% and 14%; and Mg2+ concentration by 377%, 126+ and 376%. Inorganic phosphorus increased 45% in the parotid, 25% in the subnamdibular and was unchanged in the sublingual gland. K+ concentration increased in the submandibular (12%) and sublingual (100%) glands but decreased in the parotid (24%). The Na+/k+ ratio was higher in the parotid (82%) and submandibular (37%) glands and lower in the sublingual gland (84%). The electrolyte concen-ration changes are discussed in relation to the mechanism and type of stimulation promoted by the incisor-amputations on the major salivary glands of the rat.


Chemical analysis of a sulphated macromolecule isolated from rabbit submandibular gland. Chemical analysis of a sulphated macromolecule isolated from the rabbit submandibular gland showed that about 70 per cent of the dry weight could be accounted for in terms of amino acids of which the acidic amino acids, proline and alanine were the most abundant. Total carbohydrate was 11%. Galactose was the main neutral sugar but galactosamine, glucosamine, neuraminic acid, glucose and mannose could also be demonstrated. Sulphate accounted for 1,4%. No uronic acid was found. The data indicate that the sulphated macromolecule from the rabbit gland is in fact a sulphated glycoprotein.


A virally induced osteosarcoma in rats. A model for immunological studies of human osteosarcoma. Inoculation of Moloney sarcoma virus into the medullary canal of the tibia in newborn Wistar-Lewis rats resulted in an initially localized osteosarcoma which usually metastasized to the lung and resulted in the death of the animal within four to five weeks. Tumor cells were grown in tissue culture and used as target cells in the assay of lymphocyte-mediated cytotoxicity using a microcytotoxicity and a radioisotope labeling method. Lymphocyte-mediated cytotoxicity was demonstrated throughout the course of the clinical disease as well as in a small number of animals which showed spontaneous regression of their tumors. Serum factors which could "block" or augment the cellular response were also identified. This model resembles the spontaneous osteosarcoma of humans in many respects and may be useful for studies of the human disease.


Immunogenicity of virus-induced rat osteosarcoma. The immunogenicity of a virus-induced rat osteosarcoma was studied utilizing the lymphocyte microcytotoxicity test. Intratibial injection of murine sarcoma virus (Moloney) resulted in the development of palpable tumors at the injection site which on histopathological examination appeared to be osteosarcomas. In 73 per cent of animals injected these tumors progressed and metastasized to the lungs. Lymphocytes from these "progressor" animals demonstrated an ability to kill osteosarcoma cells in vitro (as quantitated in the microcytotoxicity test) while serum from these animals abrogated or blocked the cell-mediated cytotoxicity. In the remaining animals the tumors either failed to develop or regressed spontaneously. Lymphocytes from these "regressor" animals also demonstrated cytolytic activity against osteosarcoma cells in vitro, but serum failed to block the lymphocyte-mediated cytolysis. Both regressor and progressor groups demonstrated humoral cytotoxic antibodies to tumor antigen on the basis of the ability of their serum to kill tumor cells in vitro.


Human deoxythymidine kinase. I. Purification and general properties of the cytoplasmic and mitochondrial isozymes derived from blast cells of acute myelocytic leukemia. Two forms of deoxythymidine kinase from blast cells of acute myelocytic leukemia were identified by electrophoresis. One was associated mainly with the cytoplasm and the other with mitochondria. Both isozymes were separated and purified by differential affinity column chromatography which resulted in 2416- and 1634-fold purification of the cytoplasmic and mitochondrial enzymes, respectively. Affinity gel was prepared by linkage through position 3' of deoxythymidine. Each enzyme had the same electrophoretic mobility in the purified state as it did in the enzyme derived from the corresponding subcellular fraction of the homogenate. Thymidine phosphorylase was not retarded by the affinity column. The purified cytoplasmic and mitochondrial deoxythymidine kinase had different molecular weights, sensitivities to inhibition by ammonium sulfate, activation energies for the reaction and divalent cation requirements. Adenosine, guanosine, and cytosine 3':5'-monophosphates, putrescine, spermine, and spermidine were neither activators nor inhibitors of either deoxythymidine kinase.


Virus-induced osteosarcoma in rats.

Virus-induced osteosarcoma in rats. An experimental model for osteosarcoma was developed in which, after Moloney murine sarcoma virus was injected into the tibial marrow space of three strains of inbred neonatal rats, a highly malignant neoplasm arose within ten days. This tumor was readily maintained in tissue culture and was transplantable to adult rats. It arose in the metaphyseal marrow of several bones, was locally invasive, metastasized to the lungs, and histologically resembled osteosarcoma.


Effect of airway diameter, suction catheters, and the bronchofiberscope on airflow in endotracheal and tracheostomy tubes. Pressure-flow relationships of an artificial airway-mechanical ventilator system were investigated. Endotracheal tubes varying from 7 to 9.5 mm. internal diameter and tracheostomy tubes from 7 to 10 mm. internal diameter were tested over flow-rates from 0.3 to 1.4 L. per second using a tidal volume of 500 ml. The effect of partial obstruction within these airways by suction catheters and the bronchofiberscope was examined. Depending on the internal diameter and the flow-rate, the driving pressure necessary to overcome the resistance of the tubes ranged from 5 to 20 cm. H2O. Partial obstruction of the artificial airways by suction catheters further increased this pressure. The introduction of the bronchofiberscope through an endotracheal tube of 7.5 mm. internal diameter, leaving an effective diameter of 4.9 mm., produced a driving pressure as high as 70 cm. H2O and reduced the flow rate to 50 per cent and the tidal volume to 80 per cent of its set value. Attention should be paid to duration of tracheobronchial suction while the patient is removed from the respirator since a high-grade resistance is created by passage of a suction catheter through an endotracheal tube. Bronchofiberscopy should be cautiously performed through cuffed artificial airways with at least 8 mm. internal diameter because the airway may be too comprised even if mechanical ventilatory assistance is employed.


The nature of the practice management problem.


Editorial: Practice management.

Editorial: Practice management.


The changing emphasis on practice administration.


Immunological studies in murine osteosarcoma. Immunogenicity, growth kinetics, and immunotherapy. A transplantable murine osteosarcoma is described. Following transplantation into a syngeneic mouse the tumor grows rapidly and kills the mouse with pulmonary metastases simulating human osteosarcoma. A cell-mediated antibody response is evoked in the host mouse as demonstrated by in vivo and in vitro tests. The number of pulmonary metastases may be decreased with adjunctive immunotherapy following excision of the primary tumor. Immunotherapeutic materials include BCG and isologous cells treated with Vibrio cholerae neuraminidase.


Managing a dental practice.

Managing a dental practice.


The dentist as business administrator.

The dentist as business administrator.


Weaning the patient from mechanical ventilation.


Personal growth.

Personal growth.


Influence of dental status on deaths resulting from food asphyxia.


The quest for a new impression rubber.

The quest for a new impression rubber.


A sphere compression test for measuring the mechanical properties of dental composite materials.


Some physical properties of four resilient lining materials.


The 'solubility and disintegration' test for zinc phosphate dental cements: the use of small specimens.


Congenitally missing third molars in a British population.


Vertical relationships of edentulous jaws during swallowing.


Inhibition of streptococcal adherence by human oral secretions and its possible relationship to dental caries. Oral secretions were collected from 100 human volunteers, concentrated, and assayed for their ability to inhibit glucan-dependent adherence of S mutans strains to glass. Some samples were found to contain adherence inhibition activity. The inhibitor was heat labile and nondialyzable but dependent on the presence of a dialyzable molecule. Comparison of activities with the caries experience (DMFT) showed that individuals with the highest activity had significantly lower mean caries scores, but that cariesfree donors did not differ significantly from caries-positive donors in mean adherence inhibition activity. These results suggest that some persons may have substances in their oral secretions that play a role in resistance to dental caries.


Effects of antibodies on adherence and cell-associated glucan production by Streptococcus mutans cells. Studies reported here show that hyperimmune rabbit serums can have profound inhibitory effects on adherence of S mutans to smooth surfaces and that this reduction in adherence is correlated with the reduction of CAG. The latter was measured by an assay developed in our laboratory that estimates CAG production by measuring the uptake of 14C glucose-labeled sucrose into components which can be extracted by dilute alkali. This is a direct demonstration of the effect of antibody on a metabolic function of S mutans that is important in virulence. The direct correlation bewteen inhibition of CAG production, and inhibition of adherence by an antibody, suggests that the inhibition of adherence is brought about by reduction of CAG synthesis. Further studies reported here show that the inhibition of adherence and of CAG synthesis is much more effective in homologous antiserums as compared to heterologous antiserums. These results point to the need for in vivo experiments to test the effects of vaccines on colonization by heterologous as well as homologous S mutans strains.


Some important considerations with respect to food and water consumption in animal caries studies.


Salivary proteins and the development of dental plaque.


Effects of specific immunization on dental caries in hamsters.


Serum and salivary antibodies to cariogenic bacteria in man. Antibodies in serum and parotid saliva against cell wall preparations from four serotypes of S mutans were examined in 110 subjects aged 18 to 25 years. In subjects with no detectable carious lesions, significant negative correlations were found between the DMF index and serum IgG and IgM antibodies, especially in S mutans of serotype c, whereas positive correlations were found between the DMF index and salivary IgA antibodies. In subjects with active caries, positive correlations were found between serum IgG antibodies and S mutans (serotypes c and a) and the DMF index. Sequential antibody analysis during a period of up to 32 months showed that development of carious lesions was associated with a rise in serum antibody titer to S mutans, but no change was detectable in salivary antibodies. Treatment of caries led to a decrease in serum IgG and IgM antibodies to S mutans cell wall, but in parotid saliva an increase in antibody titer to a culture extract of S mutans was found. The results support the concept of dental caries as an infective disease and suggest that serum antibodies may contribute to caries immunity in man.


Immunological aspects of dental caries. New York City, April 1-2, 1975. Closing comments.


Immunogenicity of cell wall and plasma membrane components of some oral lactic acid bacteria. It is evident that characterization of any serum with respect to its specificity, and class of antibody showing that specificity, is essential for consistent serological investigations. It must also be emphasized that a particular regimen of injection of the same immunogen preparation into the same animal species will not always produce the same immunologic response.


Comments on adherence of Streptococcus mutans.


Some serological cross-reactions between Streptococcus mutans, S sanguis, and other dental plaque streptococci. From the preliminary observations described in this report, the following conclusions may be drawn. When attempting to produce diagnostic antiserums specific for S mutans, S mitior, or S sanguis, care must be taken to eliminate cross-reactions as a result of antibodies against extracellular glucans or dextrans. Other antigenic components, associated with the cell wall, may be common to different species. One soluble protein or polypeptide antigen normally present in S sanguis and S mitior may also be demonstrated in certain strains of S mutans. Antiserums prepared against S sanguis, S mitior, or S mutans should be carefully checked for interspecies cross-reactions before being used for identification purposes.


Variations in surface polymers of Streptococcus mutans. The cell wall composition of strains of S mutans with respect to sugars and proteins appears to be correlated to the serological grouping although groups c and E are rather similar. There also appear to be similarities in the structure of the polysaccharide formed by the glycosyltransferases from organisms of serological groups b and d. However, the activity of these enzymes appears to be variable in these groups. The most noteworthy difference found was that between the three Ingbritt strains. All three strains gave identical results with regard to their cell wall composition, and presumably this would mean that they were identical serologically. However, Ingbritt LH differed considerably from both the others in the types of polysaccharide formed by their glycosyltransferases from sucrose. Ingbritt B was a reisolate from monkeys, whereas Ingbritt LH was maintained in laboratory culture, and this may explain the difference. Clearly, more work will be required to explain this difference and as c strains are commonly isolated from plaque, it would seem desirable to clear up this point.


The chargde of the seventies regarding dental auxiliaries.


Letter: Comments on "the postodoctoral opportunity".


Streptoccus mutans dextransucrase: purification, properties, and requirement for primer dextran. We attempted to purify dextransucrase from S mutans strain 6715 to investigate its properties and determine if multiple species of the enzyme existed. It was concluded that the properties of this enzyme such as the pH (5.5), temperature (37 C) optimum, and Km for sucrose (3 mM) are very similar to those reported for S sanguis, S bovis, S mutans strain OMZ-176 isozymes, S mutans strain GS-5, and the single dextransucrase purified from S mutans strain HS-6. The IEF enzyme preparation consisted of two enzyme species, possibly differing in their ability to synthesize different dextran linkages. The minor enzyme activity demonstrated a strict primer dependency. Similarly, primer dependency has been reported for dextransucrases from S mutans, S sanguis, and L mesenteroides. S mutans strain 6715 dextransucrase also showed both the insertion and stepwise mechanisms for dextran synthesis. Sucrose was the sole glucose donor, whereas dextran was a specific, highly efficient glucose acceptor. The complex primer kinetics are not fully understood at this time and require further investigation. Without linkage analysis of the products of our enzymes, we can only postulate that each enzyme has a different function in the synthesis of interresidue and interchain alpha1-3 and alpha1-6 bonds. Insoluble dextran synthesis may involve a special enzyme mechanism characteristic of S mutans. This synthesis would require both enzymes, possibly in some aggregated form, with one enzyme synthesizing endogenous primer dextran. This endogeneous primer or some cell wall polysaccharide could stimulate both enzymes to rapidly synthesize heterogeneously linked insoluble dextran.


Multicomponent nature of the glucosyltransferase system of Streptococcus mutans. The glucosyltransferases of S mutans 6715 were resolved into two major fractions. One fraction synthesized water-soluble glucans and the other made water-insoluble glucans. Each fraction was found by polyacrylamide gel electrophoresis to be composed of several catalytically active species, apparently glycoprotein in nature. Treatment of the glucosyltransferases with dextranase in the absence of sucrose caused an interconversion of enzyme forms concomitant with a time-dependent loss of enzyme activity, but did not appear to remove significant amounts of the carbohydrate associated with the enzymes. Comparison of enzyme activity patterns on polyacrylamide gels of the five different S mutans serotypes further emphasizes the complexity of the glucosyltransferase system from this group of microorganisms.


Suggestions for teaching and evaluating a course in community dentistry. A new approach to the teaching of behavioral sciences has been evaluated with one class of dental students. The findings suggest that educational environment and perceived qualities of instructor supportiveness are essential to the effectiveness of a socially oriented educational program.


Academic tenure and collective bargaining in American dental schools. In thier survey of organizational structures in American dental schools, Dilts and Fields reported that the organization and administration of dental schools are of importance in the operation and attainment of educational goals. If one institutional goal is to provide faculty with attractive working conditions, then academic tenure and collective bargaining are important. In this respect, dental schools run true to higher education form. Having great variability, tenure systems were reported to be universal in dental schools. On the other hand, collective bargaining was found to be a new phenomenon on trial. The experience of dental schools with academic tenure and the trial of collective bargaining are of some interest to all college educators. Dilts and Fields concluded that "Although dental education is traditional in nature, resisting changes as do other phases of higher education, the results indicate that dental education is dynamic and is responding to internal as well as external needs." Dental educators may wish to follow these tenure and union issues to help determine successful policies for the conditions of dental faculty employment.


Community clinics as laboratories for practice management.


Contrasting interest profiles of dental educators, practicing dentists, and graduate students.


N =1: designs for behavioral research in dentistry.


Means of improving continuing dental education.


Management of extracurricular instructional time in the semi-traditional curriculum.


Whiteriver, Arizona, satellite clinic of the UCLA School of Dentistry --a three-year report.


Editorial: Health systems agencies.

Editorial: Health systems agencies.


The basic science curriculun problem in dental education: some causes and solutions. At present there is no established purpose generally agreed on by members of the dental profession for the basic sciences in the dental curriculum. Such a purpose, supported by the entire profession, is considered a necessary first step in improving the basic science curriculum. Substantive basic science courses should be taught by instructors, holding a Ph.D. degree. These basic science instructructors, however, need the respect of the clinical faculty in order to be effective in teaching dental students. They also need to be given professional opportunity equal to that given clinical faculty if they are to commit themselves to dental education. The role of the clinical faculty in teaching the scientific basis of clinical methods is described, and the need for cooperation and communication between the basic science and clinical faculties is emphasized. Regularly scheduled faculty workshops are recommended for this purpose. A decrease in student contact time for clinical faculty is also suggested. The dental profession, led by dental educators, with advice from other health professionals, dental students, and the general public, is the logical body to define the purpose of basic science in dental education.


The dental profession: where is it now and where is it going?


Facilitating the transition to dental school.